Review began 07/27/2022 Review ended 09/15/2022 Published 09/26/2022 © Copyright 2022 Hudyma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC- BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Comparison of Cortical Bone Fracture Patterns Under Compression Loading Using Finite Element–Discrete Element Numerical Modeling Approach and Destructive Testing Nick Hudyma , Andrea Lisjak , Bryan S. Tatone , Hillary W. Garner , Jeffrey Wight , Akhil S. Mandavalli , Ifeloluwa A. Olutola , George G. A. Pujalte 1. Civil Engineering, Boise State University, Boise, USA 2. Rock Mechanics, Geomechanica Incorporated, Toronto, CAN 3. Civil Engineering - Rock Mechanics, Geomechanica Incorporated, Toronto, CAN 4. Radiology, Mayo Clinic, Jacksonville, USA 5. Kinesiology, Jacksonville University, Jacksonville, USA 6. Family Medicine, and Orthopedics and Sports Medicine, Mayo Clinic, Jacksonville, USA 7. Family Medicine, Mayo Clinic, Jacksonville, USA Corresponding author: Akhil S. Mandavalli, [email protected] Abstract Finite element analysis may not be the only method by which bone fracture initiation and propagation may be analyzed. This study compares fracture patterns generated from compression testing of bone to fracture patterns generated using a combination of both the finite element method (FEM) and discrete element method (DEM) as defined by the finite discrete element method (FDEM). Before testing, a three-dimensional bone model was developed using CT. Force and displacement data were collected during testing. The tested specimen was reimaged using CT. The solid model was discretized and material properties adjusted such that finite element-discrete element macro behavior matched the force-displacement data. A qualitative comparison of the fracture patterns demonstrates that FDEM can successfully be used to simulate and predict fracturing in bone, with this study representing the first time this has been done and reported. Categories: Medical Physics, Medical Simulation, Orthopedics Keywords: modeling, fdem, compression, fracture, bone Introduction Stress fractures are particularly common and problematic in athletes and military personnel [1]. The incidence of stress fractures in the general population is less than 4% but can be as high as 64% in the military [2-4]. Among athletes, distance runners and track and field athletes are the most susceptible to stress fractures [5]. Around 20% of distance runners are said to have had bony stress injuries [6-7]. In track and field athletes, the incidence has been reported to be 3%-25%, with female athletes being more affected [8-11] . The tibia is the most common location for stress fractures in both athletes [12-13], and military personnel [4, 14] . As such, there is a great need to understand the pathophysiology of stress fractures, since the frequencies remain high, and the injuries are debilitating. Additionally, knowledge and understanding of tibial stress mechanics and how they propagate are important. Computer modeling is commonly used to study how bone deforms and fractures under applied forces. The scientific community has embraced the continuum-based finite element method (FEM) as a way of analyzing bone deformities and fractures. This method has been shown to be excellent at determining bone strength [15] and identifying highly stressed locations in the bone where fracturing may occur during loading [16]. FEM has also been used to study the simulation of fracture initiation [17-18]. However, it is possible that FEM can be improved on by incorporating the discrete element method (DEM). Rather than having a discretized continuum to stimulate stress and deformation in materials as designated by FEM, DEM represents the object under investigation using particles, unbonded or bonded, whose changing behaviors and contact points are accounted for within the model’s calculations [19]. Using the combination of FEM and DEM in the form of a finite discrete element method (FDEM) can integrate new information; FDEM incorporates local interaction and motion between the discretized particles of certain materials as determined by DEM (such as bone) to global properties of those materials as found by FEM (such as deformability of the bone) [20]. The use of both FEM and DEM in combination allows the model to accurately simulate fracture initiation and propagation of materials placed under stress, even when a strength threshold is surpassed and failure occurs [20]. To our knowledge, FDEM has yet to be used to investigate bone fractures. However, this technique has been used extensively in rock mechanics to investigate fracture initiation and propagation within brittle materials [21] and to assess the re-initiation of pre-existing fractures within a fracture network in a rock mass [22]. Given the success of the technique in rock mechanics, a study investigating its use for the deformation and fracture of bones is warranted. In a biomedical context, the pristine (undamaged) condition would represent a healthy bone. A bone with pre-existing (healed) stress fractures could be represented by a 1 2 3 4 5 6 7 6 Open Access Original Article DOI: 10.7759/cureus.29596 How to cite this article Hudyma N, Lisjak A, Tatone B S, et al. (September 26, 2022) Comparison of Cortical Bone Fracture Patterns Under Compression Loading Using Finite Element–Discrete Element Numerical Modeling Approach and Destructive Testing. Cureus 14(9): e29596. DOI 10.7759/cureus.29596
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